Organization
WISBA HOME CARE AND PROFESSIONAL CAREER CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEAN W BASTIA NP (OWNER ADMINISTRATOR CEO)
(678) 425-4030
Entity
Organization
Contact information
Practice address
2220 ATLANTA RD SE STE 103, SMYRNA, GA 30080-1541
(800) 413-9066
Mailing address
PO BOX 1915, KENNESAW, GA 30156-8915
(678) 696-9905
(800) 410-2504
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
033-R-1532
GA
Other
Enumeration date
11/08/2017
Last updated
11/08/2017
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